ColoradoSigned law requires insurers to show rates for out-of-network care
Once effective, the signed law requires insurers to disclose rates for out-of-network care, with Colorado-regulated plans identified on covered payment statements starting January 1, 2027.
What it does
Once the law takes effect, insurers must show their middle in-network payment rate on each payment statement for claims involving care outside their networks.
Starting January 1, 2027, if the law has taken effect, insurers must identify Colorado-regulated plans and the applicable payment rule on covered payment statements.
Once the law takes effect, providers and facilities can request insurers’ payment calculation data through the insurance commissioner to check required rates. The data remains confidential.
Argument forOnce effective, identifying Colorado-regulated plans starting in 2027 could help providers find the right place to challenge an insurer’s payment.
Argument againstKeeping insurers’ payment data confidential could limit public scrutiny of how they calculate payments for care outside their networks.
More detail
Insurers must show their median in-network payment rate on each payment statement for out-of-network claims. This covers claims for care outside an insurer’s provider network. The median is the middle payment rate for care within the network. A referendum petition filed within the 90-day period delays challenged provisions unless voters approve them in November 2026. This applies to payments owed on or after the effective date: the day after 90 days following final adjournment, or, if delayed by referendum, the governor’s official declaration of voter approval.
Insurers must identify when a covered payment is for a health plan regulated by Colorado. This covers payments to health-care providers and facilities under sections 10-16-704(3)(d) and (5.5)(b). Those sections are not reproduced here. The payment statement must also identify which of the two covered payment rules applies. The law must take effect under its effective-date and referendum rules. This statement requirement begins January 1, 2027, and applies to payments owed on or after the law’s effective date.
Providers and facilities may ask the Colorado insurance commissioner to collect insurers’ data to check whether they paid the highest required rate. This covers providers and facilities receiving payments under sections 10-16-704(3)(d) and (5.5)(b). The commissioner must collect the data when a covered provider or facility requests it. The data must explain how the insurer calculates its median in-network rate and reimbursement for each service in the same geographic area. The submitted data is confidential and treated as a trade secret. A timely referendum petition delays challenged provisions until voter approval and the governor’s official declaration of the vote. This applies to payments owed on or after the law’s effective date, normally the day after the 90-day period following final adjournment.
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- May 28Governor Jared Polis SignedBecame Law
- May 22Signed by the President of the SenateMajor
- May 22Signed by the Speaker of the HouseMajor
- May 22Sent to the GovernorTo Governor
- May 7House Third Reading Passed - No AmendmentsPassed House
- Vote recorded BILL. Result: pass.Lower
- May 6House Second Reading Special Order - Passed - No Amendments
- May 5House Committee on Health & Human Services Refer Unamended to House Committee of the WholeMinor
- Vote recorded Refer Senate Bill 26-017 to the Committee of the Whole. Result: pass.Upper
- Vote recorded Refer Senate Bill 26-017 to the Committee of the Whole. Result: pass.Lower
- Apr 30Senate Third Reading Passed with Amendments - FloorPassed Senate
- Vote recorded AMEND (L.014). Result: pass.Upper
- Vote recorded BILL. Result: pass.Upper
- Apr 30Introduced In House - Assigned to Health & Human ServicesMinor
- Apr 29Senate Third Reading Laid Over Daily - No Amendments
- Apr 28Senate Committee on Appropriations Refer Amended to Senate Committee of the WholeMinor
- Vote recorded Adopt amendment L.010. Result: pass.Upper
- Vote recorded Refer Senate Bill 26-017, as amended, to the Committee of the Whole. Result: pass.Upper
- Vote recorded Adopt amendment L.009. Result: pass.Upper
- Apr 28Senate Second Reading Special Order - Passed with Amendments - Committee
- Jan 29Senate Committee on Health & Human Services Refer Amended to AppropriationsMinor
- Vote recorded Refer Senate Bill 26-017, as amended, to the Committee on Appropriations. Result: pass.Upper
- Vote recorded Adopt amendment L.006 (Attachment F). Result: pass.Upper
- Vote recorded Adopt amendment L.005 (Attachment E). Result: pass.Upper
- Vote recorded Adopt amendment L.007 (Attachment G). Result: pass.Upper
- Vote recorded Adopt amendment L.004 (Attachment D). Result: pass.Upper
- Vote recorded Adopt amendment L.003 (Attachment C). Result: pass.Upper
- Vote recorded Adopt amendment L.002 (Attachment B). Result: pass.Upper
- Jan 14Introduced In Senate - Assigned to Health & Human ServicesIntroduced
Healthcare